![]() One of the primary challenges of EEG data is its sensitivity to a breadth of non-stationary noises caused by physiological-, movement-, and equipment-related artifacts. 3Computer Human Intelligence Lab, Department of Electrical & Computer Engineering, New York University Abu Dhabi, Abu Dhabi, United Arab EmiratesĮlectroencephalography (EEG) is used in the diagnosis, monitoring, and prognostication of many neurological ailments including seizure, coma, sleep disorders, brain injury, and behavioral abnormalities.2Neuroimaging of Perception and Attention Lab, Department of Psychology, Michigan State University, East Lansing, MI, United States.1Human Augmentation and Artificial Intelligence Lab, Department of Computer Science, Michigan State University, East Lansing, MI, United States.Since Leads II and III are obviously affected by the artifact, which makes the left leg the culprit electrode.Sari Saba-Sadiya 1,2 *, Eric Chantland 2, Tuka Alhanai 3, Taosheng Liu 2 and Mohammad M. Lead II is derived from the left leg and the right arm, and Lead III is derived from the left leg and the left arm. Lead I is derived from the left and right arm electrodes. We can see that Lead I is unaffected by the baseline artifact. Knowing which limb electrodes are used for each limb lead will lead you, in this case, to the faulty electrode, which may simply be loose. This ECG offers a chance to illustrate to your students why they should understand how each lead is derived. The most preventable one is poor lead placement. Poor R wave progression can have many causes. So, V1 should be mostly negatively deflected, and V6 should be nearly all positive, with a gradual transition across the chest leads. ![]() The R waves should get more prominent as we move across the chest toward V6, while the s waves become less prominent. They should all have an RS pattern, with V1 having a small r wave and a large S wave. The precordial leads show poor R wave progression. Even though it is not premature, it could be presumed to have been conducted aberrantly. The second beat on the ECG appears different from the others, and has a P wave. We would expect to see similar signs in the lateral chest leads, V5 and V6, also. ![]() These, along with the high voltage in aVL, suggest left ventricular hypertrophy with strain. We do see abnormal ST segments and T waves in the high lateral leads I and aVL. This ECG has some intriguing abnormal signs, but we should wait for a better tracing before attempting a firm interpretation. Even though we cannot obtain “perfection”, if we settle for sloppiness, it will breed more sloppiness. Teach your students to strive for perfection. When an ECG has obvious signs of artifact, the causes of the artifact should be corrected and the ECG repeated. Such obstacles could be: seizures, tremors, vigorous resuscitation efforts underway, or patient not cooperating. If there are insurmountable obstacles preventing a technically good tracing, the circumstances should be written on the ECG. This ECG is being offered as a teaching aid, to show how artifact can affect our ability to interpret an ECG, and to encourage our students to be meticulous in obtaining a good-quality tracing whenever possible. ![]()
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